Department of Health and Human Services

The U.S. Department of Health and Human Services (HHS) is the largest grant-making agency in the federal government. It provides over 60,000 grants per year. HHS' medicare program is the nation's largest health insurer. It handles over 900 million claims per year. HHS describes itself as:

"the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves."[1]

Product promotion & conflicts of interest

Got milk? & milk mustache ad campaigns

The milk mustache campaign [2] began in 1996 with a budget of $110 million, which increased to $190 million in 1998. The Got milk? slogan was licensed to the National Milk Processor Board (MilkPEP) in 1998 to use in their celebrity print ads. [3] The force behind the campaign is National Milk Processor Board (Fluid Board), administered by the U.S. Department of Agriculture (USDA). This board was established by the USDA's Fluid Milk Promotion Act of 1990 to promote increased demands for fluid milk products. [4]

Ads featured Secretary of Department of Health and Human Services, Donna Shalala and even President Clinton in major magazines such as Health; with a circulation of over 1 million readers. According to an HHS spokesperson defending the ad against consumer groups, "no money was accepted and no ethics rules were breached." However, the same government agency charged with educating Americans about healthy eating is also promoting industry interests. It was considered a coup for the industry for the highest ranking government health official to endorse their product for free. In 1996, the USDA Economic Research Service reported that generic advertising raised fluid milk sales by approximately one billion pounds (4.4 %) between September of 1993 and August of 1994. [5] See also USDA.

Dietary Guidelines

Court rules againstsecrecy & conflicts of interest

On December 15, 1999, the Physicians Committee for Responsible Medicine and several other individual and group plaintiffs, filed a lawsuit against USDA Secretary Dan Glickman, HHS Secretary Donna Shalala and the Dietary Guidelines Advisory Committee 2000 Chair Cutberto Garza, under the Federal Advisory Committee Act (FACA). FACA requires an advisory committee to comprise a fair balance of points of view and functions and prohibits special interests. It also requires the committee to disclose all documents to the public and hold public meetings. USDA Dietary Guidelines are revised by the committee every 5 years.

The Dietary Guidelines are the principal federal policy document on diet. Their purpose is to educate consumers on dietary choices which promote health and avoid or postpone diet-related chronic diseases. They form the basis for all federal food assistance and nutrition programs, including the School Lunch Program, the School Breakfast Program, the Food Stamp Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). However, it appeared that this committee's underlying purpose was to promote certain agricultural interests. The members were to have been appointed based on their scientific knowledge of nutrition. However, out of 11 members, 6 members currently or recently had financial interests in the meat, dairy or egg industries. Even the Deputy Undersecretary of Agriculture, who participated in meetings, had a business relationship with Dannon dairy products. [6], [7]

In October of 2000, the court ruled that the USDA violated federal law by withholding documents and hiding financial conflicts of interest. PCRM's suit also charged that the government undercut the public’s ability to participate in and understand the committee’s activities. While the USDA provided information showing financial conflicts of interest for six committee members, Judge Robertson faulted the USDA for refusing to provide information involving a payment of over $10,000 to one member. According to PCRM President, Neal Barnard, M.D.:

“Having advisors tied to the meat or dairy industries is as inappropriate as letting tobacco companies decide our standards for air quality.

Earlier in the year, PCRM’s efforts to change federal diet guidelines won support from the NAACP, former Surgeon General Joycelyn Elders, Martin Luther King, III, Muhammad Ali, and many others who objected to over promotion of meat and dairy products. Lactose intolerance and diet-related diseases, such as heart disease, diabetes, and hypertension, have a higher incidence among racial minorities. PCRM gained a partial victory in February, when the committee accepted non-dairy foods, such as soy milk, as acceptable alternatives to dairy products. [8]

"Nutrition Education" programs

In March 2004, HHS launched the Healthy Lifestyles and Disease Prevention Initiative, which "encourages American families to take small, manageable steps within their current lifestyle--versus drastic changes--to ensure effective, long-term weight control."[9] It features a website www.smallstep.gov, where then-HHS secretary Tommy Thompson explains that people don't need to resort to "extreme measures"--such as following a diet fad or joining a gym--to lose weight. Tips include such bold ideas as taking the stairs instead of the elevator.

Public health experts immediately questioned the campaign's effectiveness. The Center for Science in the Public Interest called it "more talk and no real help" for millions of Americans, while former U.S. Surgeon General David Satcher said that he had "no objections to small steps," but insisted that "there also need to be big steps."[10]

The campaign also includes bizarre public service ads, including one showing boys playing on the beach and discovering a human belly, and another featuring shoppers finding a double chin in a grocery store. Print ads focus on close-up shots of heavy stomachs, thighs, and buttocks and show how they might slim down as their owners get more active.[11]

Tommy Thompson also appeared at an obesity summit in June 2004, cohosted by Time magazine and ABC news, that brought together expert speakers to discuss how to turn around the obesity epidemic. In his keynote address, Thompson emphasized the seriousness of the obesity problem, noting that "America's eating habits and lack of physical activity are literally killing us, and they're killing us at record levels." Outlining his vision for solutions, Thompson placed personal accountability front and center: "We have to do it ourselves," calling on conference participants to "go out and spread the gospel of personal responsibility." Thompson went on to explain how the food industry was becoming increasingly responsive to making changes, and heaped glowing praise on them for their alleged newfound altruism.[12]

Thompson included Kraft, Coca-Cola, PepsiCo, and McDonald's on his list of companies committed to taking positive steps. He singled out McDonald's for its "conscientious" initiatives, including its new "Balanced Lifestyles Platform," and decision to serve more low-carb options. He also lauded Coke for "promising to end exclusive contracting in schools." During questions, State Representative Charlie Brown, chairman of Indiana's Public Health Committee, asked why, if Coca-Cola was such a responsible corporate citizen, it had sent a team of five lobbyists to kill his school nutrition bill? Thompson claimed to know nothing about it.[13]

In early 2005, HHS came under fire for payments to two columnists and commentators to promote the Bush administration's pro-marriage initiatives. Neither person disclosed the payments, even as they continued to write and speak in favor of the initiative. Maggie Gallagher was paid a total of $41,500 for two federal contracts in 2002 and 2003, directly from HHS through a Justice Department grant. Her government activities included ghostwriting articles for officials, writing brochures and conducting trainings. Michael McManus was paid $10,000 through an HHS subcontractor, the Lewin Group, for presentations and trainings. [14]

Department reorganization

Leavitt's team

Once "at the helm of the Department of Health and Human Services," Secretary Michael Leavitt "is once again luring the team to follow him," Ceci Connelly of the Washington Post wrote in July of 2005: [15]

"With 67,444 employees and an annual budget approaching $600 billion, HHS is a big leap for Secretary Leavitt and his inner circle. At the EPA, they oversaw 18,000 workers and a budget of less than $8 billion. The budget for the state of Utah this year is about $4 billion.

"Leavitt, 54, has created a command structure and policy blueprint to help him direct the sprawling department, which includes the National Institutes of Health, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the Medicare and Medicaid health programs for the elderly, poor and disabled. ...He is surrounding himself with a group of 'senior counselors,' a new title at the department that gives his most trusted aides the visibility and latitude to tackle high-priority matters. The counselors meet several times a week, sometimes with Leavitt, and serve as gatekeepers to the secretary."[16]

500-day plan

"For a road map," Connelly wrote, "they are relying on Leavitt's 500 Day Plan[17]an ambitious set of goals and some steps for tackling them. The plan includes obvious areas such as modernizing Medicare and Medicaid and protecting the homeland, along with newer ones such as 'Protect Life, Family and Human Dignity' and 'Improve the Human Condition Around the World.'

"'The first principle of Leavitt management is offensive or proactive rather than defensive,' said Chief of Staff Rich McKeown. 'He positioned himself as governor, as administrator of EPA and secretary of HHS by doing things he can uniquely do and that are the most important things.'

"In particular, Leavitt is devoting much of his time to promoting the use of information technology in the health arena, preparing for a possible flu epidemic and fulfilling President Bush's mandate to make the Medicaid insurance program for the poor more efficient, McKeown said."[18]